Objective To explore the influence of psychosocial factor on post partum depression,to offer the theoretical support for intervention on the occurrence of post partum depression. Methods 45 women with the post partum depression as the case group and 84 health women as the control were investigated by using the gravida general situation questionnaire,the Edinburgh Postnatal Depression Scale (EPDS),life event scale (LES),Type A Behavior pattern questionnaire (TABQ),Eysenck Personality Questionnaire (EPQ),Social Support Rating Scale (SSRS),symptom check list-90 (SCL-90),Trait Anxiety Inventory (T-AI) and State Anxiety Inventory (S-AI). Results The education time of the case group was fewer than those of the control(9.8?3.0 vs 11.6?3.5 yrs,P

Objective To investigate the levels of peripheral blood CD8+ CD28- regulatory lymphocytes and their clinical values in the patients with multiple sclerosis (MS). Method From October 2005 to August 2008, 51 patients with active rehpsing-remitting MS were enrrolled from Department of Neurology of the First Affil-iated Hospital of Wenzliou Medical College. The diagnostic criteria for MS were the 2005 revisions to the "McDon-ald criteria". All the admitted patients received 1 g of methylprednisoione per day intravenously for 5 days, fol-lowed by 60 mg prednisone per day orally for 12 days,and tapered in 6 weeks. Fourteen patients were reevaluated after corticosteroid therapy. Twenty healthy individuals ,as normal controls,matched for age and sex with the MS patients were also enrolled in this study. The percentages of peripheral blood T cells (CD8+ CD28-, CD8+CD28+, CD8+, CD4+ CD8-) were measured by flow cytometric analysis. Parametric statistical analysis were per-formed using standard methods, and linear regression analysis was conducted using Pearson correlation test. Re-sults (1)Compared with controls,the patients with active MS had significantly lower percentage of CD8+ CD28-T cells [(18.48±9.89)% vs. (24.48±4.86)%, P <0.01], and higher percentage of CD8+ CD28+ T cells [(12.23±4.31) % vs. (8.55±3.49) %, P <0.01]. (2)The percentage of CD8+ CD28- T cells was negative-ly correlated with that of CD4+ CDS- T cells (r = -0.488, P < 0.01). (3) After corticosteroid therapy, the per-eentage of peripheral blood CD8+ CD28- / CD8+ CD28+ T cells didn' t significantly decrease or increase in 14 ac-tive MS patients (P > 0.05). Conclusions The decrease of peripheral blood CD8+ CD28- regulatory T cells might be associated with the pathogenesis of MS, and CD8+ CD28- regulatory T cells perhaps played their roles through CD4+ T cells. Corticosteroid therapy could not reverse the levels of CD8+ CD28- T cells.

Objective To investigate the diagnostic value of color Doppler ultrasonography in congenital muscular torticollis (CMT). Methods The sonographic characteristics of 62 children with CMT confirmed clinically were retrospectively analyzed. Results Abnormal ultrasound features could be visualized in all of 62 children with CMT. According to the sonogram features, 62 children were divided into 2 types: mass-forming (32/62, 51.61%) and diffuse type (30/62, 48.39%). Arterial flow signals were detected in 18 children (18/62, 29.03%); RI was 0.73-0.88. Conclusion Ultrasonography has specific value for the diagnosis of CMT.

Objective To induce experimental allergic encephalomyelitis (EAE) in female C57BL/6 mice with the extracellular domain of myelin oligedendroglia glycoprotein(MOG~(Igd)). Percentages of CD4~+ CD25~+ T cell (Tr) were tested , and also normalized expressions of Foxp3. Methods Molecular cloning technology was used to produce MOG~(Igd) fusion protein. The MOG~(Igd)-TrxA fusion protein and TrxA protein were purified by metal chelate affinity chromatography (MCAC). Mice were injected s. c. in the flank with 300 μg MOG~(Igd) in complete Frcund's adjuvant (CFA) supplemented with 4 μg/μl Mycobacterium tuberculosis. H37Rv. Mice received 0.4 ml emulsion of spinal cord homogenate of guinea pigs (GPSCH) in positive control group, and the same volume emulsiom of TrxA in negative control group, while mice served as normal control received only saline/adjuvant. Mice were monitored two times a day for continuously 30 days by double bind. Clinical scores and histopathology were evaluated. Then, mice were sacrificed. The spinal cord and brain were removed and fixed in buffered formalin. Horizontal sections taken from the central nervous system(CNS) were stained with haematoxylin and eosin (HE), and Kluver-Barrera staining. Also, immunohistochemistry was performed. Percentages of CD4~+ CD25~+ T cells were tested through flow cytometric analysis, and real-time PCR was performed to test normalized expressions of Foxp3 mRNA. Then, correlations between the two were performanced. Results Mice in both MOG group and GPSCH group shew chronic non-remitting course. The onset of disease, time when the most severe clinical symptoms happened and the clinical score between the two groups shew no significant differnces (P>0.05). However, neither in TrxA treated group nor in normal control group did animals exhibit clinical signs of EAE. Histologic sections of the brain and spinal cord taken from affected animals shew perivascular infiltration of mononuclear cells, gliosis, and multifocal demyelination. Lesions scattered throughout the CNS including brainstem, spinal cord, cerebellum, and penventricular white matter. There were significant differences between MOG group and TrxA group in the level of lesion-ceutric AQP-4 expression showing up by immunohistochemistry (P<0.05). Percentages of CD4~+ CD25~+ T cells in MOG group and GPSCH group were (4.71±1.61) % and (1.44±0.65) %, respectively, both of which were significantly lower than those in the normal control group or TrxA treated group (P<0.01). And the difference between MOG group and GPSCH group also reached statistics meaning (P<0.01). Normalized expression of Foxp3 mRNA in MOG group was 2.26± 1.97, and was not significantly higher than the 1.44±1.20 level in GPSCH group (P>0.05). However, they beth were statistically lower than that in the negative control group, namely 8.58±3.34 (P<0.01). Percentages of CD4~+ CD25~+ T cells was statistically correlated with expressions of Foxp3 mRNA (P< 0.05). Conclusion EAE induced in C57BL/6 mice with MOG~(Igd) is reproduceable. It shares the similar clinial signs and pathologic features with human multiple sclerosis(MS). Thus, we find a good way to further study the immune mechanisms of MS and also to search for the effective treatments.

Objective To investigate the role of opioid receptors and vagus and sympathetic nerves in the remifentanil-induced cardiovascular depression in rabbits. Methods Forty 2-6 months old New Zealand white rebbits of both sexes weighing 1.5-2.5 kg were randomly divided into 5 groups (n = 8 each): group Ⅰ remifentanil (group R); group Ⅱ naloxone + remifentanil (group N+ R); group Ⅲ vagus nerve cut-off +remifentanil (group V+ R); group Ⅳ epidural block + remifentanil (group S+ R) and group V vagus nerve cutoff + epidural block + remifentanil (group V + S + R). The animals were anesthetized, tracheostomized and mechanically ventilated. PaCO2 was maintained at 35-45 mm Hg. Vecuronium 0.3 mg/kg was given iv every 40 min to keep muscle relaxed. Right carotid artery was cannulated for continuous MAP monitoring. ECG was continuously monitored. A bolus of remifentanil 5.0 μg/kg was administered iv in all 5 groups. In group N + R naloxone 40μg was given iv about 2 min before remifentanil. In group V + R bilateral vagus nerves were cut off through neck incision. After HR and MAP had stabilized for 30 min, remifentanil was given iv. In group S + R epidural block was performed at L6.7 interspace with 2% lidocaine to block cardiac sympathetic nerves. When HR and MAP decreased by 20% of the baseline values and stabilized for 30 min remifentanil was given iv. In group V + S + R bilateral vagus nerves were cut off first. Then epidural block was performed before remifentanil administration. MAP and HR were recorded at 1 min before iv remifentanil administration (T0 ), at 30 s (T1), 1,2, 3, 4, 5, 10, 15 and 20 min (T2-9 ) after remifentanil administration. Results Intravenous remifentanil 5.0 μg/kg significantly decreased HR at T1 and MAP at T1-7 as compared with those at T0 in group R. Pretreatmentwith naloxone 40 μg prevented remifentanil-induced decrease in MAP but did not affect remifentanil-induced decrease in HR in group N + R. Vagus nerve cut-off and sympathetic block induced by epidural anesthesia performed before iv remifentanil did not affect remifentanil-induced cardiac depression in group V + R, S + R and V + S + R. Conclusion Opioid receptors and vagus and sympathetic nerves are not related to remifentanil-induced decrease in HR. Remifentanil induces decrease in MAP by activating opioid receptors.

Objective To investigate the correlation between plasma cystatin C (CysC) level and carotid atherosclerotic plaque in patients with ischemic stroke.Methods The clinical data in patients with acute ischemic stroke were analyzed retrospectively.According to the results of carotid artery ultrasound,the patients were divided into either a non-plaque group or a plaque group.Then the plaque group was redivided into a stable plaque subgroup and a vulnerable plaque subgroup.Multivariate logistic regression analysis and Pearson correlation analysis were used to explore the risk factors for carotid atherosclerotic plaque.Results A total of 226 patients with acute ischemic stroke were enrolled,172 of them had carotid plaque,and 54 had no plaque.Of the patients with carotid plaque,94 were stable plaque and 78 were vulnerable plaque.The age (71.82 ± 9.94 years vs.60.74 ± 13.81 years; t =6.160,P =0.014),proportion of patients with ischemic heart disease (11.6％ vs.1.9％; x2=6.169,P=0.020),systolic blood pressure (148.770± 21.007 mm Hg vs.142.240 ± 19.404 mm Hg; t =2.029,t =0.044),plasma CysC concentration (1.046 ± 0.438 mg/L vs.0.860 ±0.214 mg/L; t =3.006,P =0.003),and carotid IMT (1.122 ±0.278 mm vs.0.878 ±0.250 mm; t =5.762,P=0.000) in the plaque group were significantly higher than those in the non-plaque group.Multivariate logistic regression analysis showed that the age (odds ratio [OR] 1.079,95％ confidence interval [CI] 1.044-1.116; P=0.000) and IMT (OR 31.450,95％ CI 6.233-158.692; P=0.000) was the independent risk factor for carotid plaque,while there was no significant independent correlation between the plasma CysC level and carotid plaque (P =0.217).Only IMT in the stable plaque subgroup was significantly higher than the vulnerable plaque group (1.176 ±0.285 mm vs.1.058 ±0.258 mm; t =-2.824,P =0.005),and it was the independent protective factor for the carotid plaque stability (OR 0.195,95％ CI 0.059-0.064; P =0.007).Pearson correlation analysis showed that the plasma CysC level was positively correlated with the age (r =0.375,P =0.000) and serum creatinine level (r =0.462,P =0.000),but it was not significantly correlated with carotid IMT (r =0.075,P =0.264).Conclusions In patients with ischemic stroke,no correlations were found between the plasma CysC level and carotid atherosclerotic plaque,plaque stability,and IMT.

Objective To evaluate the feasibility of CEUS in Crohn discasc (CD) activity.Methods Thirty-nine patients with CD were analyzed.The clinical disease activity index of 18 cases were less than 150 (inactivity),and 21 cases were between 150 and 450 (activity).The thickness of intestinal walls were measured and Limberg classification were determined by power-Doppler results.The CEUS was performed,and the parameters including rise time,peak intensity,mean transit time,time from peak to one half,wash in slope and time to peak were statistical analyzed.Results The thickness of the lesions,peak intensity and wash in slope of activity CD were greater than those of inactivity CD,which had significant difference (all P＜0.05).The Limberg classification of type Ⅰ was 1 case,type Ⅱ was 4 cases,type Ⅲ was 10 cases and type Ⅳ was 6 cases in activity CD.The Limberg classification of type Ⅰ was 10 cases,type Ⅱ was 7 cases and type Ⅲ was 1 case.The Limberg classification were mainly type Ⅲ and type Ⅳ in activity CD,and type Ⅰ and type Ⅱ in inactivity CD,which had significant difference (P＜0.001).Conclusion CEUS can provide quantitative parameters in CD activity and has great clinical value.

Inflammatory bowel disease(IBD) is a complex multifactorial disease characterized by chronic recurrent intestinal inflammation.The etiology of IBD has not yet been determined, and relevant studies have focused on the genetic susceptibility, immune response, intestinal microbiome and environmental factors of the host.Studies have found that interleukin-10 receptor A(IL-10RA)plays important roles in the pathogenesis of IBD.IL-10RA can not only affect the intestinal barrier, but also affect the intestinal immune system.Furthermore, the mutation of IL-10RA itself is highly correlated with very early-onset IBD.

Objective:To study the effects of sacubitril valsartan sodium on vascular sclerosis and ventricular remodeling in patients with ischemic cardiomyopathical coronary heart disease.Methods:A prospective research method was adopted. One hundred and eighty-six patients with coronary heart disease who were treated in Hangzhou Ninth People′s Hospital from January to December 2021 were selected and divided into control group and observation group by random digits table method, with 93 cases in each group. The control group adopted routine treatment method of aspirin + metoprolol + nitroglycerin + captopril according to the guideline, while the observation group was additionally treated with sacubitril valsartan sodium on the basis of the control group. The clinical efficacy, vascular endothelial function and hardness, cardiac function, ventricular remodeling and adverse reactions were compared between the two groups.Results:The total effective rate of treatment in observation group was significantly higher than that in control group: 96.77%(90/93) vs. 87.10%(81/93), and there was statistical difference ( P<0.05). After treatment, the brachial artery flow-mediated dilation in observation group was significantly higher than that in control group: (14.46 ± 2.80)% vs. (13.09 ± 2.74)%, the level of endothelin-1 was significantly lower than that in control group: (73.32 ± 9.63) ng/L vs. (77.47 ± 10.35) ng/L, and there were statistical differences ( P<0.05). After treatment, the left ventricular ejection fraction (LVEF) in observation group was significantly higher than that in control group: (50.87 ± 3.52)% vs. (49.72 ± 3.71)%, the left ventricular end-systolic diameter, left ventricular end-diastolic diameter and ventricular remodeling indicators of interventricular septal thickness and left ventricular mass index were significantly lower than those in control group: (38.26 ± 5.18) mm vs. (40.05 ± 5.20) mm, (50.49 ± 4.33) mm vs. (52.08 ± 4.25) mm, (8.95 ± 0.39) mm vs. (9.08 ± 0.41) mm, (118.49 ± 9.58) g/m 2 vs. (121.58 ± 9.62) g/m 2, and there were statistical differences ( P<0.05). There were no statistical differences in the levels of total cholesterol, low-density lipoprotein cholesterol and high-density lipoprotein cholesterol after treatment between the two groups ( P>0.05). There were no statistical differences in the incidences of adverse reactions between the two groups ( P>0.05). Conclusions:Sacubitril valsartan sodium has a good clinical efficacy in the treatment of coronary heart disease, and it can improve cardiac function and vascular sclerosis and reverse ventricular remodeling. In addition, it has no significant adverse reactions and is conducive to disease recovery.

Objective:To explore the diagnostic efficacy of percutaneous lymphatic contrast ultrasound (LCEUS) combined with clinicopathological features in the diagnosis of breast cancer sentinel lymph node (SLN).Methods:A total of 135 breast cancer patients who underwent sentinel lymph node biopsy and axillary lymph node radical resection were prospectively collected in the Affiliated Hospital of Nanjing University of Chinese Medicine from July 2018 to June 2021, and the breast masses and SLNs were evaluated by routine ultrasound, contrast-enhanced ultrasound and LCEUS within one week before surgery. The surgeons recorded the patients′ clinical characteristics before surgeries, and the pathology of the masses and SLNs were recorded after surgeries. Univariate analysis and multivariate Logistic regression analysis were used to explore the correlation between ultrasound clinicopathological features of breast cancer and SLN metastasis, then to establish a model, and evaluate the diagnostic efficacy of the model.Results:Univariate analysis showed that SLN metastasis of breast cancer was associated with age, axillary palpation of enlarged lymph nodes, pathological type of mass, clear hilum of lymph nodes, cortical thickening of lymph nodes, marginal blood flow in lymph nodes, and the appearances of LCEUS(all P<0.05). Multivariate Logistic regression analysis showed age, palpation of axillary lymph nodes and the appearances of LCEUS were independent predictors of SLN properties, the OR values were 6.90 ( P=0.030), 16.06 ( P<0.001) and 12.71 ( P<0.001), respectively. The regression equation was Logit(P)=0.887+ 1.932× axillary lymph node palpation + 2.776× marginal blood flow + 2.542×LCEUS. Conclusions:LCEUS combined with marginal blood flow in lymph nodes and palpation of axillary lymph nodes can help to determine the SLN state.